Cardiovascular Diseases Clinical Trial
To find genes important in the susceptibility to coronary heart disease.
BACKGROUND:
Coronary heart disease (CHD) is a complex disorder constituting a major health problem in
Western societies. The study assesses the unknown genetic background of CHD by investigating
the most common familial dyslipidemia predisposing to CHD, familial combined hyperlipidemia
(FCHL). The population prevalence of FCHL is estimated to be 1-2 percent and the disorder
affects 10-20 percent of families with premature CHD. In FCHL, serum cholesterol,
triglycerides, or both are elevated. Both environmental and genetic factors are suggested to
affect the complex FCHL phenotype. Since the molecular basis of FCHL is unknown, a
significant number of genetically predisposed individuals remain unidentified and exposed to
premature CHD. The study uses samples from the genetically isolated population of Finland.
DESIGN NARRATIVE:
The investigators will use the unique study samples from the genetically isolated population
of Finland and apply molecular genetic tools to first restrict the genetic locus they have
identified and then to characterize the causative gene underlying the FCHL disorder on
chromosome 1q21. Specifically, they first aim to further restrict the region by dissecting
the different component traits. They will genotype an extended study sample consisting of
all available family members of 61 FCHL families with dense sets of microsatellite markers
and single nucleotide polymorphisms to fully utilize the refined quantitative phenotype
information in fine mapping. Second, they aim to build a transcript map over the critical
region on 1q21-q23 and to identify the causative FCHL gene among the regional candidate
genes. This region on 1q21-q23 is orthologous to a region on mouse chromosome 3, where a
locus (Hyplip 1) for combined hyperlipidemia has been identified. They have analyzed the
human homolog of the Hyplip 1 gene but disappointingly, the human Hyplip 1 gene was found 10
Mb from the peak linkage markers and no evidence emerged for Hyplip 1 as a causative gene
for FCHL. Their targets to identify the FCHL gene are currently the genes showing strongest
association near the linkage peak. The FCHL gene will then be functionally characterized to
prove the biological dysfunction. Characterizing one gene for FCHL would improve their
understanding of molecular mechanisms of cardiovascular disease, and potentially lead to
more accurate diagnosis, treatment and prevention.
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